JP2653418B2 - Cardiopulmonary support equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cardiopulmonary support apparatus which is inserted into a blood vessel such as an aorta or a vena cava and performs a part of a pump function similar to a heartbeat.

[0002]

2. Description of the Related Art In the case of transient heart failure or cardiac shock immediately after an open heart surgery, a balloon pump is generally used. While such pumps are an effective means to reduce cardiac afterload, reduce myocardial oxygen consumption, increase coronary artery blood volume and promote heart function, This pump only acts as a substitute for a part of the pump action in conjunction with the movement, and if the gas exchange function of the lungs is reduced along with the deterioration of the heart function, this pump alone is not sufficient, It requires an oxygenator such as a lung.

On the other hand, when the function of oxygenating venous blood is impaired due to a remarkable decrease in the gas exchange function of the lungs, an extracorporeal circulation circuit combining an artificial lung and a blood pump is used to assist from the vein to the artery. Cardiopulmonary support techniques that bypass blood may be used. This can be expected to be a powerful circulatory support that has both a heart pump function and a lung gas exchange function.

Recently, a device having a shape / function similar to a blood oxygenator collecting member of a membrane-type oxygenator using a hollow fiber is used, and the device is inserted directly into the vena cava to add oxygen to the blood. Treatment is being attempted.

[0005]

However, when the above-mentioned extracorporeal circulation circuit is used, both an artificial lung and a blood pump are required, which makes the apparatus complicated and the handling thereof complicated. is there. In addition, when a device having a shape / function similar to that of the blood oxygenator collecting member is used, when the device is placed in a blood vessel, it may hinder blood flow and cause a blood clot to form in a blood retention portion. Evils can also occur. This has the disadvantage that the range of application of the device is limited.

Accordingly, the present invention has been devised in view of the above circumstances, and an object of the present invention is to add oxygen to blood while simultaneously assisting a part of the heart's pumping function, and to leave the blood in a blood vessel. Another object of the present invention is to provide a cardiopulmonary function assisting device which has low blood resistance and is unlikely to cause thrombus, has excellent versatility, has a simple structure and is easy to operate.

[0007]

A first aspect of the present invention.
The cardiopulmonary function assisting device described in the above, a gas conduit connected to a driving device that supplies and sucks oxygen or a mixture of oxygen and other gas at the proximal end side, and a header connected to the distal end of the gas conduit. A plurality of balloons, each having a proximal end connected to the distal end of the header independently of each other and formed of an oxygen-permeable membrane, comprising: When the oxygen or gaseous mixture is simultaneously supplied to a plurality of balloons via the balloon, the balloons expand independently of each other, and oxygen is added to the blood surrounding the balloon through the balloon, and the surrounding blood is diffused. And blood is filled around each balloon when gas is suctioned from the balloon.

In the cardiopulmonary function assisting apparatus according to the present invention, a plurality of gas inlet pipes arranged in parallel with each other are connected at their base ends to supply means for supplying oxygen or a mixture of oxygen and another gas. And, an inflow side header connected to the tip of each of these gas inflow pipes, and a plurality of balloons each having an end connected to the tip of the inflow side header and formed of an oxygen-permeable membrane, A plurality of outflow headers to which the other ends of these balloons are connected, respectively, and these outflow headers are respectively connected to the ends, are arranged in parallel with the inflow header, and the other end side is oxygen or oxygen and other A plurality of gas outlet pipes connected to suction means for sucking a gas mixture with the gas,
When the oxygen or the mixed gas is simultaneously supplied from the supply means to a plurality of balloons via the gas inflow conduit and the inflow side header, the balloons are independently expanded, and the oxygen permeates through the balloon. While being added to the blood around the balloon and removing the surrounding blood, and when the simultaneous gas is sucked from a plurality of balloons via the outlet side header and the gas outlet pipe by the suction means, each of them is removed. It is characterized in that blood is filled around the balloon.

[0009]

In the cardiopulmonary function assisting apparatus of the present invention, a plurality of balloons repeatedly expand and contract at the same time, thereby adding fresh oxygen to the blood and periodically removing and filling the blood around the balloon. Repeatedly assists some of its pumping functions, similar to a heartbeat.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A cardiopulmonary function assisting apparatus according to an embodiment of the present invention will be described below with reference to the accompanying drawings. 1 and 2 showing a cardiopulmonary function assisting device according to this embodiment, FIG. 1 shows a state in which a bag-shaped balloon is expanded,
FIG. 2 shows a state in which the balloon is deflated.

In these figures, reference numeral 1 denotes a cylindrical gas conduit having open ends. The proximal end of this gas conduit 1
A driving device (not shown) (eg, an intra-aortic balloon pump system or a pneumatic artificial heart driving device) which is provided outside the body and supplies gas (oxygen) to the gas conduit 1 includes:
It is connected. Further, a header 2 made of a cylindrical body having the same diameter as that of the gas conduit 1 and having both ends opened is attached to the tip of the gas conduit 1 so as to communicate with each other coaxially. The gas conduit 1 and the header 2 are made of a material that does not transmit gas and liquid and has appropriate rigidity and appropriate flexibility. For example, polyvinyl chloride, polyurethane, silicone resin, etc. Can be used. Also,
The dimensions of the gas conduit 1 and the header 2 are arbitrarily selected according to the thickness and length of the blood vessel used,
For example, the total length of both can be set to about 50 cm to 150 cm, the outer diameter to about 3 mm to 20 mm, and the thickness to about 0.2 to 1.0 mm.

A plurality (three in this embodiment) of intravascular oxygenated balloons 3 are attached to the distal end of the header 2. When inflated, these balloons 3 have the shape of an elongated ellipsoidal tube, the proximal end of which is attached to the open end of header 2 respectively. Further, the portion of the open end of the header 2 where the balloon is not attached is sealed, so that the gas introduced into the header 2 from the gas conduit 1 does not leak to the outside. , Simultaneously enter the plurality of balloons 3 and inflate them. The header 2
In order to uniformly supply the gas supplied thereto to the plurality of balloons 3, for example, the plurality of balloons 3 are attached so as to be arranged at equal intervals, or the balloons 3 are placed in the header 2. The same number of channels are formed, and each balloon 3 is attached to each channel. Therefore, when a plurality of balloons are attached to the gas conduit 1 so that the gas is uniformly supplied therein, the header 2 can be omitted. It is preferable that the surface area of the balloon is increased by forming folds or providing irregularities on the surface of the balloon.

The connection between the balloon 3 and the header 2 or the gas conduit 1 can be made by welding, bonding, caulking, fusing, or the like, depending on the material of both. In any case, it is important that gas and blood do not leak from the connection points.

The balloon 3 can be formed by a gas-permeable homogeneous membrane, for example, silicone rubber. The dimensions of this balloon also differ depending on the place of use. For example, the overall length is 5 cm to 50 cm, and the thickness is 0.
05mm-0.3mm, and the thickness when expanded,
It can be set to 10 mm to 35 mm to be approximately the same as the vessel inner diameter.

The gas (oxygen) permeability of the balloon 3 is as follows:
It is desirable that the higher the value, the lower the resistance of gas exchange with blood. When the balloon 3 is inflated / deflated, like the existing intra-aortic balloon pump, the membrane itself has little expansion and contraction, but rather the pressure at the time of expansion of the oxygen-enriched gas (for example, the gauge pressure) so that the membrane is folded upon deflation. At 20mm
It is desirable that the pressure is adjusted and used (for example, a positive pressure of about Hg to 400 mmHg) and a contraction pressure (for example, a negative pressure of about -20 mmHg to -400 mmHg in gauge pressure).

Next, the operation of the cardiopulmonary function assisting device having the above configuration will be described. A plurality of balloons 3 are indwelled in a blood vessel such as an aorta or a vena cava, the gas conduit 1 is penetrated through the blood vessel, and its proximal end is taken out of the body and connected to a driving device. And
An oxygen-enriched gas such as pure oxygen or a mixture of oxygen and air (the oxygen concentration is preferably 21% to 100%, which is appropriately selected depending on the condition of the patient) is supplied from the driving device into the gas conduit 1 by an arrow A in FIG. Inject from the direction. As a result,
This gas flows into the respective balloons 3 via the header 2 and simultaneously expands the balloons 3 as shown in FIG. During and after the expansion, oxygen in the gas is sequentially transmitted through the balloon and diffused outside, that is, into the blood.
As a result, oxygen is added to the blood around each balloon while simultaneously removing the blood around the balloon. Subsequently, as shown by an arrow B in FIG. 2, oxygen-rich gas is sucked from the gas conduit 1, and all the balloons 3 are simultaneously deflated as shown in the drawing. As a result, blood is filled around each balloon. In this manner, by repeatedly supplying and aspirating gas to the gas conduit 1, fresh oxygen is added to the blood, and blood around all the balloons is periodically eliminated and filled. Assists in some of its pumping functions. Further, by alternately repeating the expansion and the deflation of the balloon, the blood flow resistance can be relatively reduced as compared with the case where the balloon is constantly expanded. Therefore, the retention of blood is also reduced, the possibility of thrombus formation is reduced, and the range of use is expanded. Further, as described above, the configuration is simple and the operability is good.

Next, a cardiopulmonary function assisting apparatus according to another embodiment will be described with reference to FIGS. 3 and 4 showing the cardiopulmonary function assisting device according to this embodiment, FIG. 3 shows a state in which the tubular balloon is expanded,
FIG. 4 shows a state in which the balloon is deflated.

In these figures, reference numeral 4 denotes a gas inflow pipe having both ends opened, and reference numeral 5 denotes a gas outflow pipe of the same shape provided alongside the gas inflow pipe 4. And
An inflow header 6 and an outflow header 7 are connected to the distal ends of the gas inflow pipe 4 and the gas outflow pipe 5, respectively.
) Is mounted. These balloons 8 have an elongated tubular shape with both ends opened, one end at the open end of the inlet side header 6, the other end at the outlet side header 7,
It is installed so that it can be distributed between them.

The gas inlet pipe 4, gas outlet pipe 5, inlet side header 6 and outlet side header 7 of this embodiment are made of the same material and similar dimensions as the gas conduit 1 and header 2 of the above embodiment. And a tubular balloon 8
Are formed of the same material as the previous balloon 3 and similar dimensions.

Next, the operation of the cardiopulmonary function assisting device having the above configuration will be described. All the tubular balloons 8 are indwelled in blood vessels such as the aorta and vena cava, and the gas inflow pipe 4 and the gas outflow pipe 5 integrated therewith are penetrated through the blood vessel and extended out of the body. The end is connected to the supply means of the drive and the proximal end of the gas outlet pipe 5 is connected to the suction device (suction means), respectively (actually formed as one unit with the suction device of the drive). Then, an oxygen-rich gas such as pure oxygen or a mixture of oxygen and air is injected into the gas inflow pipe 4 from the driving device in the direction of arrow C in FIG. As a result, this gas flows into each balloon 8 via the inflow side header 6, and expands the balloon 8 as shown in FIG. During and after the expansion, oxygen in the gas is sequentially transmitted through the balloon and diffused outside, that is, into the blood. As a result, oxygen is added to the blood around all the balloons, and at the same time, the blood around the balloons is eliminated. Subsequently, the supply of gas to the gas inflow pipe 4 is stopped, and the gas in the balloon 8 is simultaneously sucked from the gas outflow pipe 5 in the direction indicated by the arrow D in FIG. Let it. As a result, blood is filled around each balloon. In this manner, by repeatedly supplying and aspirating gas to the balloon 8, fresh oxygen is added to the blood, and blood around the balloon is periodically eliminated and filled. Assists some of its pump functions. Further, by alternately repeating the expansion and the deflation of the balloon, the blood flow resistance can be relatively reduced as compared with the case where the balloon is constantly expanded. Therefore, the retention of blood is also reduced, the possibility of thrombus formation is reduced, and the range of use is expanded. Further, as described above, the configuration is simple and the operability is good. In addition,
In the cardiopulmonary function assisting apparatus of this embodiment, since the gas inflow pipe 4 and the gas outflow pipe 5 must be provided in parallel, there is a disadvantage that the pipe diameter becomes larger than that of the previous embodiment, The movement of the oxygen-enriched gas is in only one direction, and the effect is that fresh oxygen-enriched gas can always be supplied into the balloon 8.

In each of the above embodiments, the balloon is formed into an oblong tube shape and a straight tube shape. However, the present invention is not limited to such a shape. For example, in the first embodiment, the base end is The brush tip shape may be thicker and thinner toward the tip. In the second embodiment, the first
The elliptical tube shape as used in the embodiment may be used, and may be variously changed depending on the place of use, purpose of use, and the like. Further, other members can be appropriately changed according to the purpose of use and the like.

[0022]

According to the cardiopulmonary function assisting device of the present invention, oxygen is added to blood at the same time as assisting a part of the pumping function of the heart, and blood clots are generated even if the blood is left in the blood vessel with little resistance. Therefore, it is excellent in versatility, simple in configuration, and operable.

[Brief description of the drawings]

FIG. 1 is a side view schematically showing a cardiopulmonary function assisting apparatus according to an embodiment of the present invention, with a balloon in an expanded state.

FIG. 2 is a side view schematically showing the concentric lung function assisting device with the balloon in a deflated state.

FIG. 3 is a side view schematically showing a cardiopulmonary function assisting apparatus according to another embodiment of the present invention, in which a balloon is in an expanded state.

FIG. 4 is a side view schematically showing the concentric lung function assisting apparatus with the balloon in a deflated state.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... gas conduit, 2 ... header, 3, 8 ... balloon, 4 ... gas inflow pipe, 5 ... gas outflow pipe, 6 ... inflow side header, 7 ... outflow side header.

Claims (2)

(57) [Claims] 1. A gas pipe connected to a driving device for supplying and sucking oxygen or a mixed gas of oxygen and another gas at a base end side, a header connected to a distal end of the gas pipe, and a header. A plurality of balloons, each having a proximal end independently connected to each other and formed of a membrane permeable to oxygen, and a plurality of balloons from the driving device via a gas conduit and a header. When the oxygen or the gas mixture is supplied to the balloons at the same time, each of the balloons expands independently, oxygen is transmitted through the balloon and added to blood around the balloon, and excludes surrounding blood;
A cardiopulmonary function assisting device characterized in that when gas is sucked from the balloon, blood is filled around each balloon. 2. A plurality of gas inflow pipes whose base ends are connected to supply means for supplying oxygen or a mixed gas of oxygen and another gas, and a plurality of gas inflow pipes arranged in parallel with each other, and respectively connected to the distal ends of these gas inflow pipes. A plurality of balloons each having one end connected to the leading end of the inflow-side header and each formed of an oxygen-permeable membrane, and a plurality of balloons each having the other end connected thereto. Outflow side headers, and these outflow side headers are respectively connected to the ends, are arranged in parallel with the inflow side header, and the other end side is connected to suction means for sucking oxygen or a mixed gas of oxygen and another gas. A plurality of gas outlet pipes, and when the oxygen or the mixed gas is simultaneously supplied from the supply means to the plurality of balloons via the gas inlet pipe and the inlet side header, the balloons respectively Expand independently, Oxygen penetrates the balloon and is added to the blood around the balloon, and at the same time, removes the blood around the balloon.Suction means simultaneously sucks gas from a plurality of balloons through the outlet side header and the gas outlet pipe. A cardiopulmonary function assisting device characterized in that blood is filled around each balloon when the operation is performed.